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目的探讨各种类型胎儿膈疝的声像特征、妊娠结局及预后。方法利用二维超声对可疑胎儿膈疝病例进行胸腹部多切面扫查,同时启动彩色多普勒血流显示胸腔内异常回声的血流特征,并仔细排查有无其他合并畸形。所有产前超声诊断的胎儿膈疝病例均得到产后手术或引产后病理证实。结果14例胎儿膈疝产前超声均表现为胸腔异常回声、腹围缩小和羊水过多。其中左侧膈疝10例,右侧膈疝3例,双侧膈疝1例。单纯膈疝9例,膈疝合并其他结构异常5例。结论产前超声可对胎儿膈疝的类型和程度进行准确判断,指导临床处理,有助于改善预后及优生优育。
Objective To investigate the sonographic features, pregnancy outcome and prognosis of various types of fetal diaphragmatic hernia. Methods Two-dimensional ultrasonography was used to scan thoracic and abdomen in suspected cases of fetal diaphragmatic hernia. At the same time, color Doppler flow imaging was used to display the abnormal blood flow characteristics in the thorax and carefully examined for any other combined deformities. All cases of fetal diaphragmatic hernia diagnosed by prenatal ultrasound were confirmed by postnatal surgery or postnatal pathology. Results Fourteen cases of fetal diaphragmatic hernia prenatal ultrasound showed abnormal pleural echoes, abdominal circumference narrowing and polyhydramnios. Of which 10 cases of left diaphragmatic hernia, right diaphragmatic hernia in 3 cases, bilateral diaphragmatic hernia in 1 case. 9 cases of simple diaphragmatic hernia, diaphragmatic hernia combined with other structural abnormalities in 5 cases. Conclusion Prenatal ultrasound can accurately determine the type and degree of fetal diaphragmatic hernia, and guide the clinical treatment, which can help to improve prognosis and prenatal and postnatal care.